SEPT. 8, 2000

Medi-Minutes
HHS Announces New Standard Format for Electronic Claims

The Department Health and Human Services (HHS) has announced standard formats to streamline the processing of health care claims, reduce the volume of paperwork, save the U.S. health care systems billions of dollars, and provide better service for providers, insurers, and patients.

The new regulations establish standard data content and formats for submitting electronic claims and other administrative health transactions. All health care providers will be able to use the electronic format to bill for their services, and all health plans will be required to accept these standard electronic claims, referral authorizations, and other transactions.

At present, different insurers require different electronic and paper forms from health care providers filing claims. Under the new regulation, all electronic health transactions must follow the single standardized format. Providers will still be allowed to use paper forms, but the simplified process is expected to encourage more electronic filing.

The greater use of electronic transactions and the elimination of inefficient paper forms could save the health care industry as much as $29.9 billion over 10 years.